镰状细胞病患儿使用替代技术进行自动换血的疗效、安全性和成本效益
Efficacy, safety and cost-efficiency of using an alternative technique for automated exchange transfusion in pediatric patients with sickle cell disease.
作者信息
Villar Prados Maria B, García De Jesús Ricardo, Fernández Sein Alicia, Iglesias García Manuel
机构信息
Pediatric Critical Care Section, Department of Pediatric, UPR School of Medicine, San Juan, PR 00936-5067.
出版信息
Bol Asoc Med P R. 2010 Jan-Mar;102(1):13-7.
BACKGROUND
Sickle cell disease (SCD) patients suffer complications requiring simple and/or exchange transfusion. In 1999 we developed an automated exchange technique using infusion pumps and vascular catheters (IV Pump Method).
OBJECTIVE
To prove that IV Pump Method is cost-efficient, and as safe and effective as automated cell separators.
METHODS
Retrospective chart review of SCD patients requiring exchange transfusion admitted to PICU from 2003-2009. Evaluated method used, complications, costs, and Hemoglobin S% (HgS%) change, excluding patients not requiring exchange transfusion.
RESULTS
Cost-reduction with IV Pump Method is around $1000. Average HgS% reduction using IV Pump Method was 30.3 vs. 28.8 in Blood Cell Separator group (p = 0.84). We had no complications or mortalities, with the majority of patients being male (p = 0.03) and on the oldest age group (11-19 y/o) for both methods.
CONCLUSION
The IV Pump Method is a safe, effective, and cost-efficient alternative to perform exchange transfusion.
背景
镰状细胞病（SCD）患者会出现需要单纯和/或换血输血的并发症。1999年，我们开发了一种使用输液泵和血管导管的自动换血技术（静脉输液泵法）。
目的
证明静脉输液泵法具有成本效益，且与自动血细胞分离机一样安全有效。
方法
对2003年至2009年入住儿科重症监护病房（PICU）需要换血输血的SCD患者进行回顾性病历审查。评估所使用的方法、并发症、成本以及血红蛋白S%（HgS%）的变化，不包括不需要换血输血的患者。
结果
静脉输液泵法可降低成本约1000美元。静脉输液泵法使HgS%平均降低30.3，血细胞分离机组为28.8（p = 0.84）。我们没有出现并发症或死亡病例，两种方法的大多数患者为男性（p = 0.03）且属于年龄最大的年龄组（11 - 19岁）。
结论
静脉输液泵法是进行换血输血的一种安全、有效且具有成本效益的替代方法。
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